SPECIAL REPORT: Experts warn giving too much plasma can be dangerous

Pia Murray is like many college students, spending much of her time studying or working at her part-time job. But when she needs extra cash, she has long had a unique solution: selling her plasma.

Plasma is in blood and can save lives. What’s sold per visit is worth up to tens of thousands of dollars in resale value. But sellers only get about around $50, and experts say frequent sellers could be putting themselves at risk.

A big question remains: Just how often can someone safely sell plasma? The FDA and American Red Cross wildly differ — with the nonprofit accepting donations no more than once every four weeks, and the FDA allowing people to give plasma eight times in that same period. That’s 13 times per year for the Red Cross and 96 times per year for the FDA.

A Carolina News & Reporter investigation found some donors were exhausted, others severely bruised and others faced long-term health problems, according to health experts. That matters because the centers tend to cluster near universities and low-income neighborhoods, both communities that can be considered vulnerable. The question is whether the word is getting out about the possible risk. 

“I had a patient who did develop a bleeding disorder while being a frequent plasma donor, and it turned out that giving so much plasma depleted his own blood clotting factors,” said Dr. Morey Blinder, an adult hematologist at Washington University in St. Louis. “And so he ended up having a bleeding disorder with a lot of nosebleeds and a lot of problems.”

Murray, a 23-year-old master’s student at the University of South Carolina, has been selling plasma frequently since she was 18. She said she has left exhausted at times — once too worn down to work. 

“I need the cash,” Murray said.

Her apartment complex is just 250 feet from the nearest plasma donation center, CSL Plasma on Assembly Street in downtown Columbia, near USC’s urban campus. Some experts say the locations are no coincidence – situated closely to college students or other people likely to need quick cash.

“I know my plasma is helping people, but honestly, I do it because it helps me, too,” Murray said. “It’s been a steady source of income for years, and with the center so close to where I live, it just makes sense to keep going.”

Some experts say it does not make sense to go as often as twice per week as the FDA guidelines allow.

“Worldwide, the usual standard is once a week,” Blinder said. “In the United States, it’s allowed more often than that, and it’s to the company’s advantage to do that, because then you don’t have to recruit as many people.”

The United States is the only country in the world that permits plasma draws as frequently as twice per week, allowing donors to give up to 96 times per year, Kathleen McLaughlin, a journalist and book author who has investigated plasma donations, told the Carolina News & Reporter.

Blinder said frequent plasma donations not only deplete blood clotting factors but also reduce antibodies essential for fighting infections.

“The concern is that the long-term depletion of natural antibodies could increase the risk of infections or lead to other long-term health issues,” he said.

Neither the FDA or the American Red Cross would agree to interviews about the disparity in how often people can give plasma.

An uncomfortable experience for some

Connor Fry, a sophomore biochemistry student at USC, donated plasma last summer at a center in his hometown of Kingwood, Texas.

He never went back.

“I donated last summer solely because I was broke and needed the money,” Fry said. “I only went once, and the entire experience was miserable. Something felt off with the needle, and I ended up sitting in that chair for 45 minutes in excruciating pain.”

Fry pushed through the discomfort, believing he had no other option.

“I kept telling myself to just tough it out because I needed the money,” he said. “I didn’t know I would end up with a huge bruise on my arm.”

That bruise was a hematoma, he said. Hematomas can be caused by the blood vessels getting damaged or nicked during needle insertion.

Other side effects can be worse. 

Giving plasma regularly can reduce crucial immune proteins, according to Dr. Kathy Puca, senior medical director at Versiti Blood Center of Wisconsin.

“There is a risk of low immunoglobulins if you keep donating — particularly if you’re donating on a very frequent basis, like two times a week, or even weekly,” Puca said. “As we say in medicine, everyone’s an individual, and so you have to assess them individually.”

Immunoglobulins are essential antibodies that help the body fight off infections. 

“If their immunoglobulin levels were too low, and based on other individual factors, they might not be able to fight off infections as effectively,” Puca said. “So, if they were to catch a cold or a viral infection, it could be a little more severe in them than it would be for someone else — and it might last a little longer, too.”

Luke Zifchak, a junior at USC and infrequent giver, said he has to hydrate and eat a good meal before giving plasma or he’ll “seriously regret it.”

“It really takes it out of me. So, I try to avoid going unless I absolutely have to,” he said, calling the aftereffects unpredictable and sometimes draining.

“Each time I donate is different,” he said. “Sometimes, I’m so tired I have to lay in bed for the rest of the day to get my strength back.”

The business of plasma donation

Ten of millions of Americans sell their blood plasma each year, according to the FDA. It fuels a global multibillion-dollar industry.

Plasma is light yellow and rich in proteins and antibodies essential for treating patients with immune disorders, clotting conditions and other medical needs. 

Giving plasma is more complicated than giving blood. 

A phlebotomist inserts a needle in the person’s arm to take blood. The plasma is removed, and the blood is given back to the person without it. It’s used to create medications and therapies, some of which save lives.

Plasma collected at for-profit centers is stored in coolers before being exported to a processing facility, ultimately making its way to patients at medical facilities.

A person’s plasma could sell for several thousand to tens of thousands of dollars from a single session.

The person giving the plasma gets $25 to $100 at one local center.

At the CSL Plasma on Assembly Street near USC, where Murray gives plasma, the payout depends on a variety of factors. Those who weigh more get more money because they’re able to give more plasma. For someone who weighs 110 to 139 pounds, the first session of the week gets people $25, but the second earns them $40. So they’re incentivized to give a second time.

Plasma is sold for $100 to $200 per gram, according to Blinder. A 150-pound person can provide 70 grams of plasma per session, which a company could sell for about $7,000 to $14,000.

“The companies that collect the products also then do the processing … they give you pennies, and they sell it for dollars,” he said. “If you’re going to do this and get paid for it, there should be some fairness to it. People that are donating are not getting their fair share.” 

CSL Plasma, which has locations throughout the United States., initially offers the highest payouts for their first five donations — but only if the person makes all five within 30 days. 

First time compensation rates at CSL Plasma on Assembly Street*:

Weight Class	1st donation	2nd donation	3rd donation	4th donation	5th donation
110-139 lbs	$100	$50	$50	$50	$50
140-169lbs	$100	$75	$50	$50	$50
170-199 lbs	$100	$100	$50	$50	$100
200-229 lbs	$100	$100	$50	$50	$100
230-400lbs	$100	$100	$50	$50	$100

*Fees may vary by location and are subject to change.

Repeat customer compensation rates at CSL Plasma on Assembly Street*:

Weight Class	First donation of the week	Second donation of the week
110-139 lbs	$25	$40
140-169 lbs	$40	$45
170-199 lbs	$42	$50
200-229 lbs	$45	$55
230-400 lbs	$45	$60

*Fees may vary by location and are subject to change.

FDA, Red Cross won’t do interviews

The U.S. Food and Drug Administration allows for-profit plasma donation centers to collect donations up to twice a week, requiring two-day waits between sessions, to get to that maximum of 96 donations per year.

In comparison, the American Red Cross, a nonprofit that does not compensate for donations, permits draws once every 28 days, with an annual limit of 13 sessions. It also only accepts plasma from donors with AB blood, the universal plasma type.

A regional American Red Cross spokesperson in South Carolina declined an interview request and would not answer questions sent by email, including why the nonprofit recommends donors give no more than once every 28 days. 

The Red Cross also did not respond to questions about potential health risks of donating more often, the research behind its policy or why its limits are stricter than paid plasma centers.

“At this time, we are unable to provide additional assistance for your article,” spokeswoman Stephanie Wesseling wrote.

The FDA also did not respond to questions.

The business of plasma donation

Kathleen McLaughlin, an American journalist who has spent more than a decade investigating the plasma industry in the United States and China, has written extensively on its economic impact and ethics, authoring the book Blood Money.

“We export plasma drugs and plasma all around the world,” McLaughlin said. “We export more human blood plasma than we do soybeans. So, it’s a massive industry.” 

The United States provides 70% of the world’s plasma, according to industry data reported by the University of Colorado’s Boulder Today.

McLaughlin said she found that payment rates vary by location nationally, with lower-income areas being offered less money.

“One of the things that we could do is establish a fair plasma minimum wage where people know exactly what they’re going to get paid,” McLaughlin said. “And it represents their time and the fact that they’re giving up a part of their body.” 

McLaughlin also spoke about Wang Shuping, a scientist who worked in China’s plasma industry and was forced to flee the country due to her outspoken criticism of corruption within the system. After coming to the United States., Wang recognized alarming similarities in how the plasma industry operated. She has since passed away, but McLaughlin spoke with her about her findings.

“I think that they were pressuring donors to come back too often and donate too much plasma, and that profits were at the center of the system, rather than, you know, people’s lives,” McLaughlin said. “And I think that she really felt that the exchange of this amount of money to lure people in the doors to donate plasma was dangerous.”

The Federal Deposit Insurance Corporation, which insures bank deposits and does financial risk assessment, published a 78-page report in 2022 examining the financial implications of giving plasma. Researchers found many who gave plasma needed quick cash. 

Researchers also found anecdotal evidence suggesting negative health impacts in some cases, including weakness, fatigue and susceptibility to blacking out and getting infections. The report pointed to some givers ultimately losing money due to health problems and work declines.